There is no 'weekend effect' in elective orthopaedic surgery

Area of Science:

• Orthopaedic Surgery
• Health Services Research

Background:

• The 'weekend effect' hypothesis suggests poorer patient outcomes due to hospital admission or surgery timing.
• Evidence for this effect in elective orthopaedic surgery remains inconclusive.

Purpose of the Study:

• To investigate the existence of a 'weekend effect' in patients undergoing elective orthopaedic procedures.
• To determine if surgery timing influences patient outcomes, specifically length of stay and mortality.

Main Methods:

• Retrospective analysis of electronic patient records for elective orthopaedic surgery patients.
• Inclusion of demographic and International Statistical Classification of Diseases and Related Health Problems (ICD-10) coding data.
• Multivariate analyses to identify risk factors for prolonged hospital stays and assessment of 30-day mortality based on surgery day.

Main Results:

• Analysis of 892 patients undergoing total hip or knee replacements over one year.
• No significant difference in average length of stay between weekday (91.3%) and weekend (8.7%) surgery groups (P = 0.95).
• Increasing age and American Society of Anesthesiologists (ASA) score of 2 were associated with prolonged hospitalization; no deaths occurred in weekend surgery patients.

Conclusions:

• The 'weekend effect' is not observed in elective orthopaedic surgery.
• Patient age and ASA score are significant predictors of prolonged hospital stays.
• Surgery timing on weekdays versus weekends does not appear to affect outcomes for these elective procedures.